Chen Li Ern, Zamakhshary Mohammed, Foglia Robert P, Coplen Douglas E, Langer Jacob C
St. Louis Children's Hospital, Washington University School of Medicine, Saint Louis, MO, USA.
Pediatr Surg Int. 2009 Mar;25(3):223-7. doi: 10.1007/s00383-008-2306-6. Epub 2008 Dec 16.
Prolonged surgical wait times are a problem in many health care systems. We used data from two pediatric surgical centers, one Canadian and one American, in order to determine if increased wait times are related to rates of incarceration and adverse outcomes.
Data were collected for children under the age of 2 who presented with an inguinal hernia to either the emergency department or clinic in the two hospitals in 2002 and 2003.
Infants in the Canadian center were older at presentation and were more likely to present to the emergency department. Wait time for hernia repair was longer in the Canadian than the American hospital (99 +/- 103 vs. 27 +/- 53 days, P < 0.001). The incidence of incarceration was higher in the Canadian hospital, and infants in the Canadian center were more likely to have episodes of recurrent incarceration. Emergency department usage was greater in the Canadian hospital both at the time of diagnosis as well as during the waiting period for surgery.
Prolonged wait time for inguinal hernia repair in infants is associated with a higher rate of incarceration as well as greater usage of emergency department resources. These data are important for those surgeons working in systems with limited resources in which strategies to shorten wait times are necessary.
在许多医疗保健系统中，手术等待时间过长是一个问题。我们使用了来自一家加拿大和一家美国儿科手术中心的数据，以确定等待时间的增加是否与嵌顿率及不良后果相关。
收集了2002年和2003年在两家医院急诊科或诊所就诊的2岁以下腹股沟疝患儿的数据。
加拿大中心的婴儿就诊时年龄较大，且更有可能前往急诊科就诊。加拿大医院的疝修补等待时间比美国医院更长（99±103天对27±53天，P<0.001）。加拿大医院的嵌顿发生率更高，加拿大中心的婴儿更有可能出现复发性嵌顿。在诊断时以及手术等待期间，加拿大医院的急诊科使用率更高。
婴儿腹股沟疝修补术等待时间延长与更高的嵌顿率以及急诊科资源的更多使用相关。这些数据对于在资源有限的系统中工作的外科医生很重要，在这些系统中，缩短等待时间的策略是必要的。
